Practice-based preceptoral residency training in family practice.

BACKGROUND AND OBJECTIVES

Highly specific accreditation requirements have led to a uniform approach in US family practice continuity training. In this paper, we describe an experiment in practice-based preceptoral continuity training.

METHODS

We assessed the impact of assigning a resident to a private faculty practice for the second- and third-year levels of family practice continuity training. Data analysis included comparisons of practice demographics, clinical content, training costs, and resident assessment of training quality.

RESULTS

The preceptoral resident practice better approximated community demographic patterns than did the established residency practice. However, the preceptoral resident practice had relatively fewer visits for hypertension and diabetes mellitus than did the established residency, preceptoral site faculty, and National Ambulatory Medical Care Survey practices. Resident training at the preceptoral site resulted in a positive training expense differential of $69,300 calculated on an annual per third-year resident basis. The preceptoral resident expressed high levels of satisfaction with the quality of family practice center training.

CONCLUSIONS

Practice-based preceptoral continuity training in family practice appears feasible in terms of clinical content exposure and may offer substantial financial advantages. Important questions remain, particularly about the quality of teaching and supervision in a preceptoral training model.